Factors associated with the development of paediatric chronic otitis media by age 9:A prospective longitudinal cohort study of 6560 children

Objective: To study social, health and environmental factors associated with the development of chronic otitis media (COM) by age 9. Method: Prospective, longitudinal, birth cohort study of 6560 children, reviewed at age 9. COM defined as previous surgical history or video-otoscopic changes of tympanic membrane retraction, perforation or cholesteatoma. Non-affected children used control group. Results: Univariate analysis demonstrated an association between COM and otorrhea, snoring, grommet insertion, adenoidectomy, tonsillectomy, hearing loss, abnormal tympanograms and preterm birth. Multivariate analysis suggests many of these factors may be interrelated. Conclusion: The association between COM and otorrhea, abnormal typmanograms and grommets supports the role of the Eustachian tube, otitis media (with effusion or acute) in the pathogenesis of COM. The role of snoring, adenoidectomy and tonsillectomy is unclear. Associations suggested by previous studies (sex, socioeconomic group, parental smoking, maternal education, childcare, crowding, siblings) were not found to be significant predictors in this analysis.